Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder worldwide, affecting more than 5 million Canadians each year (that's 1 in every 6 people). It includes symptoms such as indigestion, bloating, excessive gas, constipation, and/or diarrhea. However, a proper diet is one of the ways IBS can be managed. A common strategy has always been to incorporate ‘healthy’ food and avoid the ones that worsen the symptoms,
however, some are surprised to find out that a diet rich in fruits and vegetables can sometimes actually make symptoms worse. This is where we look at something called the low FODMAP diet, which has been clinically proven to help ¾ of IBS sufferers. Let’s learn more.
In this diet plan, the food items are classified as low, moderate, and high food. People with IBS must avoid high foods and consume low foods to determine a decrease in symptoms.
However, if a person consumes low food excessively for long periods of time, it can also be harmful to gut microflora and increase your risk of nutrient deficiencies, so it's always important to talk to your doctor, naturopath or dietician about how long to avoid these foods, when to determine benefit and how to reintroduce.
How Does A Low FODMAP Diet Work?
A low FODMAPs diet aims to help you learn which foods (if any) you do not tolerate and which are the trigger for your IBS. The diet consists of a 3 step process, as follows:
1 - Elimination
This phase can range from 3 to 8 weeks, depending on the person’s health and condition. In this, the individual is required to eliminate all high FODMAP food from their diet. Remember, the FODMAP list is extensive and can restrict some key nutrients for some individuals, so it’s always best to work with a professional through this phase.
2 – Reintroduction
If after elimination, the symptoms significantly reduce or resolve, it’s safe to conclude that one or more high FODMAP foods are a trigger for IBS symptoms. You then must start incorporating FODMAP foods into your diet in a systematic way to determine the source of the intolerance. Generally, a person must eat the FODMAP foods at least once every day to every other day for ~3 servings to identify the trigger foods, increasing the quantity of the food each time. Monitoring symptoms through exposure will help determine which sugar groups are safe and which ones are not.
3 – Maintenance
Now that the trigger food is traced, a person can return to their original diet while limiting the food that produces the IBS symptoms. At this point, most people are able to return to their original diet (minus a few possible avoidances) without symptoms.
Key Foods To Avoid
Vegetables: mushrooms, asparagus, cauliflower, beetroot, onions, and garlic
Fruits: cherries, mangoes, watermelon, peaches, pears, apples, and apricots.
Dairy: lactose-containing cow milk, cottage cheese, yogurt, ricotta cheese, ice cream, and custard
Grains And Cereals: rye, wheat, kidney beans, soy products, lentils, and chickpeas.
Sweeteners: Honeys, agave nectar, high fructose corn syrup, cough medicine, sorbitol, and sugar-free gums.
Many lists suggest slightly modified food restrictions, and the list you see above is very simplified. The most valuable resource I generally recommend for patients embarking on a FODMAP diet is the smartphone app made from Monash University called ‘Monash University FODMAP diet’. The guidelines of Monash University tend to be the most detailed and well-researched.
The Bottom Line
The low FODMAP diet plan is proven and has helped many people with Irritable bowel syndrome. However, make sure to contact a professional dietitian or Naturopath Doctor who is versed on the FODMAP restrictions before following any diet plan. Many people stick with the low FODMAP diet for a long time because it eliminates IBS and improves overall well-being, however, you must way out the benefits against the risk in every case.
Resources:
https://www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/
https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/